| Objective:Three-dimensional image data of carotid plaques were obtained by three-dimensional ultrasound(3D-US)and analyzed by vessel plaque quantification software(VPQ).Gray scale median(GSM),Normalized wall index(NWI)and Plaque volume(PV)parameters were got,data were compared and analyzed before and after the drug treatment.The purpose of this study was to investigate the value of GSM,NWI and PV parameters in quantitative evaluation of drug treatment effect,and to analysis the relationship of three parameters and blood lipids,smoking.Methods:1.Subjects: Eighty-one patients with 93 carotid plaques were enrolled from May 2015 to October 2015.Patients received 3D-US,3.0T MRI and blood lipid examination including total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)before drug treatment,and then began to accept atorvastatin therapy with a daily dose of 20 mg for 6-12 monthes.3D-US and blood lipid examination were repeated from March 2016 to September2016 with an average interval of 10.8 monthes,and 55 patients were followed successfully with a total of 62 plaques obtained.2.Patients were divided into groups:(1)According to data acquired by MRI and3D-US before treatment,the patients were divided into low-risk group,medium-risk group,and high-risk group;(2)According to smoking or not during the drug treatment,patients were grouped: smoking cessation group and smoking group.3.The gray scale median(GSM),normalized wall index(NWI)and plaque volume(PV)parameters of each group were analyzed by plaque analysis software(QLAB VPQ),and the data were analyzed and compared.The changes of the parameters and the difference between the groups were analyzed.Results:1.There was no significantly diference in serum TC,TG,LDL-C and HDL-C levels among the groups before treatment.After treatment,the serum TC and LDL-C levels were significantly lower than before(P < 0.05),the difference of TG and HDL-C levels was not significantly,and the LDL-C levels in high-risk group were significantly lower than those in other groups(P<0.05).2.The GSM value of high-risk and medium-risk group was significantly increased after drug treatment than before(33.87±6.53 vs 27.50±7.82 、 47.35±5.42 vs44.56±4.36,P<0.05),and low-risk group has no significantly change(62.01±10.68 vs 63.13±10.41,P>0.05).The NWI value of the high-risk group was significantly decreased after drug treatment than before(0.40±0.08 vs 0.44±0.07,P < 0.05),medium-risk and low-risk group has no significantly change(0.43±0.09 vs0.43±0.09 、0.46±0.10 vs 0.45±0.07,P>0.05).The PV value of the high-risk group was significantly decreased after drug treatment than before(0.25±0.09 vs 0.29±0.08,P<0.05),medium-risk and low-risk group has no significantly change(0.28±0.18 vs0.28±0.18 、0.27±0.17 vs 0.26±0.16,P>0.05).3.Before and after treatment,the difference of GSM in each group was negatively correlated with the difference of LDL-C(r=-0.28,p=0.03),the difference of NWI,PV in each group was not correlated with the difference of TC,TG,LDL-C and HDL-C(P>0.05).4.The GSM value was significantly increased in smoking-cessation group than smoking group(51.14±15.64 vs 46.85±18.47,P<0.05),while that was significantly decreased in smoking group than smoking-cessation group(43.34±12.96 vs45.58±12.76,P < 0.05).The NWI value was significantly decreased insmoking-cessation group than smoking group(0.42±0.08 vs 0.44±0.07,P<0.05),while that was significantly increased in smoking group than smoking-cessation group(0.54±0.09 vs 0.46±0.09,P<0.05).The PV value was significantly decreased in smoking-cessation group than smoking group(0.28±0.17 vs 0.30±0.15,P<0.05),while that was significantly increased in smoking group than smoking-cessation group(0.31±0.09 vs 0.23±0.10,P<0.05).Conclusion:The GSM,NWI and PV were obtained by 3D-US can be used as reliable indicators for the clinical evaluation of carotid plaque drug therapy,especially for medium-risk and high-risk plaques.Among the three indicators,GSM is more sensitive and has better clinical value.Smoking-cessation and smoking group three parameters changed opposite,indicating that smoking in plaque drug treatment process has a negative impact. |
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